Do Electoral Dry Laws Lead to Short-Term Public Health Gains?

Year: 
2017
Topic: 
Education - Health
Politics and Economy

There is a consensus regarding the existence of a strong relationship between excessive alcohol consumption and public health, but much less is known about policy tools that are effective in reducing the negative externalities associated with excessive alcohol consumption. This column summarizes a policy evaluation in which variation in the availability of alcohol within Brazilian municipalities over time generated by state-imposed electoral dry laws is used to estimate the impact of restricting access to alcohol on public health outcomes.

A Brief History of Electoral Dry Laws in Brazil

Electoral dry laws were adopted uniformly across the country after its re-democratization in the mid-1980s until the mid-2000s. During this period, there was a gradual increase in legal opposition to such restrictions, led especially by associations of bar and restaurant owners. For example, in 2006, the Brazilian Association of Bars and Restaurants (Abrasel) filed a lawsuit in the state of São Paulo, claiming that the restrictions caused a significant loss in revenue for businesses and that their impact on public safety was, at best, marginal, given that the police have more effective ways to maintain the public order. After a long and protracted judicial battle, the lawsuit was eventually settled in favor of Abrasel. Judicial rulings in similar lawsuits filed in other Brazilian states were varied, reflecting both the differences in the individual views of judges, as well as the specific socioeconomic and political characteristics of each state. As a consequence of all the legal opposition, state authorities have had the autonomy to decide whether or not to implement alcohol bans during elections since 2010. Some state authorities have mandated their municipalities to either ban alcohol sales or to allow unrestricted sales, while others have decided to transfer the authority to restrict alcohol access directly to their municipalities.

The lawsuits had the effect of sparking public debate regarding the rationale for electoral dry laws, which many Brazilians viewed as arbitrary, especially in the more urban centers. Electoral dry laws prohibit the sale and purchase of alcoholic beverages in all commercial establishments. They also prohibit the public consumption of alcoholic beverages legally purchased at other times. Those in support of the laws argue that restricting access to alcohol helps the police to maintain the public order on Election Day, by reducing the likelihood of violent confrontations between supporters of different local political factions and decreasing the probability that constituents come to the polling stations under the influence of alcohol. Indeed, electoral violence is an important and long-standing unresolved issue in Brazil, especially in the poorer and less developed regions of the North and Northeast. During the 2012 Municipal Elections, at least 22 politicians were murdered in the months before Election Day, leading more than 400 municipalities to request additional police forces from the federal government to help preserve the public order on Election Day (Barbassa, 2012).

Do temporary restrictions on access to alcohol during election periods affect public health outcomes and, if so, by how much?

Electoral dry laws and public health: Evidence from the 2012 Municipal Elections in Brazil

In a recent study (Nakaguma and Restrepo, Forthcoming), we exploited the fact that 11 out of 27 Brazilian states imposed on their 2,733 municipalities the decision to ban alcohol sales during the 2012 Municipal Elections. While all municipalities held elections on the same day, some of them adopted the state-imposed alcohol bans and others did not. This heterogeneous adoption of electoral dry laws allowed us to disentangle the effect of the alcohol bans from the direct impact that elections might have on public health outcomes.

We evaluated the public health impact of electoral dry laws with detailed, day-level data on road traffic accidents, traffic injuries, and hospital admissions. Using variation in the availability of alcohol within Brazilian municipalities over time resulting from the state-imposed electoral dry laws, we found that temporary alcohol bans caused a reduction in the number of road crashes (19%) and traffic injuries (43%). When we unpacked the effect on traffic injuries, we found that the bans caused a reduction in the number of light injuries (38%), serious injuries (51%), and fatal injuries (71%). Taken together, these results indicate that electoral dry laws led to reductions in both the number of accidents and injuries (an extensive-margin change), as well as reductions in the severity of the injuries resulting from traffic accidents (an intensive-margin change). Consistent with these findings, we also found that alcohol bans caused hospitalizations due to road traffic accidents to fall by an average of 17%. These improvements were largely concentrated in the hours the alcohol ban was in effect.

Did the electoral dry laws result in savings for Brazil’s public healthcare system?

An analysis of traffic‐related hospitalization costs allowed us to estimate the lower bound of the negative externality associated with excessive alcohol consumption in our context, as measured by the financial burden placed on Brazil’s public healthcare system. Our analysis indicated that electoral dry laws saved Brazil’s public healthcare system $100,000 per day. Brazil’s Institute of Applied Economic Research estimated that hospitalization costs account for 13-32% of the economic costs of road traffic accidents (Instituto de Pesquisa Econômica e Aplicada, 2003, 2006). Using our traffic‐related hospital cost savings estimate of $100,000 as a benchmark, this implies that the total cost savings may be on the order of $300,000-$800,000 for a single day of alcohol bans.

Conclusions

Our analysis revealed that, in addition to helping to reduce the risk of Brazil’s political process from being disrupted by a breakdown in the public order, temporarily restricting access to alcohol during the 2012 Municipal Elections led to short-term public health gains as measured by economically important reductions in road crashes, traffic injuries, and traffic-related hospitalizations.

Driving and traffic congestion tends to intensify during and surrounding special events, so our analysis produces an important policy insight, especially for jurisdictions where excessive alcohol consumption and risky driving behavior are rampant. Temporary bans on alcohol sales may be a useful policy tool to promote a smooth political process while simultaneously reducing the negative externalities of excessive alcohol consumption.


References:

Barbassa, J. 2012. “Brazil: 22 Murders Connected to Local Elections.” Associated Press, http://www.seattletimes.com/nation-world/brazil-22-murders-connected-to-local-elections/, last accessed June 1, 2017.

Instituto de Pesquisa Econômica e Aplicada. 2003. “Impactos sociais e econômicos dos acidentes de trânsito nas aglomerações urbanas.”

Instituto de Pesquisa Econômica e Aplicada. 2006. “Impactos sociais e econômicos dos acidentes de trânsito nas rodovias Brasileiras.”

Nakaguma M and Restrepo B. Forthcoming. “Restricting Access to Alcohol and Public Health: Evidence from Electoral Dry Laws in Brazil,” Health Economics.

Share this